Patient Education

Endometrial Hyperplasia

Endometrial hyperplasia is a condition that happens when the uterine lining grows more than is necessary. Usually, it is a benign (non-cancerous) condition, but it has been known to lead to uterine cancer. If you have hyperplasia, this page should cover the basic information about your condition.

WHAT IS THE ENDOMETRIUM AND ENDOMETRIAL HYPERPLASIA?

The endometrium is another name for the lining of your uterus, made out of blood vessels and tissue. Every month, it grows and thickens to prepare for a potential pregnancy. However, if pregnancy does not occur, the endometrium sheds itself through your vagina. This is called menstruation or period. The hormones estrogen and progesterone are responsible for the changes in your reproductive system every month during a cycle called the menstrual cycle. Estrogen builds up and triggers the growth of the endometrium and the release of an egg for fertilization.

After the egg is released progesterone is secreted and prepares endometrium for potential pregnancy. If the egg is not fertilized, the progesterone levels will drop, signaling your monthly period.

When women are near or in menopause, their bodies no longer produce as much estrogen and progesterone and their periods stop. Oftentimes, women will take hormone replacement therapy to replace the losses of both hormones, or they will take just estrogen. However, just estrogen without progesterone (if woman still has uterus) can cause uncontrolled growth of the uterine lining, which is called endometrial hyperplasia. Sometimes, the cells in the endometrium can then become abnormal, which is called atypical hyperplasia, which sometimes leads to cancer.

WHO IS AT RISK FOR DEVELOPING ENDOMETRIAL HYPERPLASIA?

Endometrial hyperplasia is most likely to affect women who:

  • Are in the years around menopause
  • Are overweight/obese
  • Skip menstrual periods or do not have them
  • Have postmenopausal bleeding
  • Have diabetes
  • Have polycystic ovary syndrome
  • Take estrogen without progesterone (and still have uterus) to relieve symptoms of menopause

WHAT ARE THE SYMPTOMS OF ENDOMETRIAL HYPERPLASIA?

The main, most common symptom is abnormal vaginal bleeding.

HOW CAN DOCTORS TEST FOR ENDOMETRIAL HYPERPLASIA?

  • Ultrasound: A small device is placed inside your vagina, as well as fluid in your uterus. Ultrasound use waves to make pictures of your uterine lining.
  • Biopsy: In your doctor’s office, a small narrow tube is inserted into the uterus to take a sample of the cells, which may cause mild pain and cramping. This sample will then be sent to a lab to be analyzed.
  • Dilation and Curettage (D&C): During this procedure, the vaginal walls are held open, and a special device called a curette is inserted to remove a small sample of uterine lining, which is then studied in a lab. You may be given anesthesia for this procedure, and it may be performed alongside a hysteroscopy.

HOW IS ENDOMETRIAL HYPERPLASIA TREATED?

In most cases, it can be treated with the hormone progesterone.  This can oftentimes cause vaginal bleeding. How much progesterone you will need depends on your health and condition. If the problem persists, surgery may be necessary. A hysterectomy may be an option if you do not want more children and you have cells that may become cancer. Some forms of endometrial hyperplasia have a high incidence of endometrial cancer and are primarily treated with surgery and require prompt intervention.

HOW CAN I PROTECT MYSELF AGAINST ENDOMETRIAL HYPERPLASIA?

There are several ways to reduce your risk of developing endometrial hyperplasia:

  • If you take estrogen after menopause and still have a uterus, make sure to take progesterone as well to balance it out.
  • If you don’t have monthly periods, you should take progesterone to prevent the uterine lining from growing too thick. Birth control pills may help regulate periods and protect against buildup of endometrium. If you cannot tolerate birth control pills, progesterone alone can be used to achieve the same goal.
  • If you are overweight, losing weight may help, as well as making you much healthier in general.
  • If you have abnormal or irregular periods, talk to your gynecologist to be evaluated as this may sometimes be caused by endometrial hyperplasia or cancer is some women.

IN CONCLUSION…

In most cases, endometrial hyperplasia is treatable and benign. It is important to talk to your doctor about how to prevent further problems with endometrial hyperplasia that could become cancerous.